Sorry this isn't a mixed-status question, but I can't find another Forum for the question... I was accidentally infected by my partner 9 months ago, now because we're both poz (and monogamous) he wants to continue to have unprotected sex. Is it ok? What will it do to my viral load if I am the receptive partner?

Response from Dr. Remien

I am not a physician and not really qualified to offer you details about all of the medical health issues to be considered. My understanding is that there are a number of things to be concerned about when it comes to unprotected sex between HIV positive partners. There is always the issue of other sexually transmitted infections and this would include old, as well as new ones. So even if you are both monogamous at this time, I assume there are prior sexual histories for both of you. Then of course there is the issue of what to do, if sex does begin to occur outside of the relationship. In regards to the possibility of "re-infection" with HIV, there is controversy in the field about this. It is certainly possible, but appears to be somewhat rare for re-infection to occur. Some people are infected with multiple strains of HIV when they first become infected. But it is my understanding that once an HIV infection is established in someone, it is not very easy to be infected with another strain ... but it is possible. And the main concern about this is the possibility of getting a strain that could have a different resistance than the one you have, leading to complications in treatment. And then there remains the concern on the part of some, that there can develop a "super strain" of HIV where they combine genetically, possibly leading to serious problems. Aside from these types of concerns, I am not aware of other reasons for unprotected sex between the two of you to directly cause an increase in viral load. However, these are complicated issues and again, I am not a physician and do not have the expertise to do thorough justice to these issues.

I think you and your boyfriend should discuss this matter with your physician(s) so that you can learn more about the general issues as well as identify the possible concerns there may be given your health status and your health history.

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